After the implantation of a stent in a heart artery, patients should know that now more than ever they must improve their lifestyle, continue with routine follow-ups and comply with the prescribed medication.
In the following sections, we are going to give certain recommendations and try to resolve basic doubts that may arise.
What treatment should I follow after stent implantation and for how long?
- ANTIAGGREGANTS:
The stent is a metal prosthesis implanted inside an artery and to prevent thrombi from forming, treatment is necessary to prevent the body from rejecting it, especially in the first months. Antiplatelets are drugs that act on platelets, reducing their ability to aggregate and form thrombi. In other words, we want the blood to be a little more “fluid.”
The time that antiaggregation must be maintained can be variable, since it depends on multiple factors. Your cardiologist will individualize each case, assessing age, risk of bleeding, diabetes, need for other anticoagulant drugs, etc…
- STATINS:
They are drugs that allow adequate cholesterol control. It has been widely demonstrated that patients with ischemic heart disease and a stent need to have lower cholesterol levels than the healthy population, and achieving this increases the durability of the stents and the patient's life expectancy. Absolute contraindications to statins are few and side effects infrequent. Despite this, it is common to find patients who have stopped taking the statin after stent implantation due to fear when reading the leaflet or because of its sometimes bad publicity on the Internet.
The cornerstones of treatment for ischemic heart disease after stent implantation are therefore antiplatelet agents and statins . Other medications will depend on factors such as blood pressure, diabetes, ventricular function, and the presence of arrhythmias, and will be added to the treatment as needed by each patient.
Can I return to work?
The rate of return to work has clearly improved in the last decade, partly due to the early implantation of stents in acute situations such as myocardial infarctions, allowing for a reduction in cardiac damage and therefore in possible long-term complications (such as arrhythmias and heart failure). Stent implantation alone is not the determining factor for determining sick leave, and very few types of work become contraindicated after its placement. Other parameters, such as heart strength and the type of work, must be taken into consideration. The advent of stents has contributed to a higher rate of return to work in patients with ischemic heart disease.
Can I play sports after a stent?
Part of the measures after stent implantation include lifestyle changes and adequate control of cardiovascular risk factors such as tobacco, high blood pressure, dyslipidemia, diabetes or a sedentary lifestyle.
Thus, when a patient asks us if they can perform physical activity after stent implantation, our response as cardiologists is that not only is it not contraindicated, but it is advisable to perform moderate and predominantly aerobic physical activity. Establishing the ideal time to return to exercise or the advisable level of intensity should be a joint decision made with your cardiologist taking into account many clinical variables.
How long does a stent last? Should it be changed?
The stents have no expiration date, so they do not have to be replaced. The idea is that when a stent is implanted, it is for life, although there is always a risk that the stent will become occluded. The latest generation stents and the drugs used today have made it possible to reduce the rate of new stent obstruction. Even so, if this were to occur, the obstructed stent would not be removed either, but a new catheterization would be performed again to dilate said stent, or if necessary, another stent could be implanted inside the previous one.
Can I drive with a stent?
Ischemic heart disease can increase the relative risk of accident. Just as when we talk about returning to work or physical activity, the possible risks in driving after the implantation of a stent depend more on the clinical context in which it was implanted and the possible arrhythmias, than on the stent itself. , the decision must be made together by your cardiologist and taking into account, in addition to the reason for the stent implantation, the type of vehicle to be driven.
In conclusion…
The stent has improved the quality of life of patients with ischemic heart disease, but we already know that the process does not end there. Subsequent continuous cardiological monitoring, lifestyle changes, and maintaining prescribed medication are essential in all patients. And of course don't be afraid to ask, we are here to solve.
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Doctor Daniele Gemma
Specialist in Cardiology , Hemodynamics Department
Follow-up after stent placement is carried out by the Hemodynamics and Interventional Cardiology Unit of UICAR.